Physiological evaluation and exercise system

ABSTRACT

A system for isolating, evaluating and exercising the muscle groups of the human hand, wrist, arm and shoulder including an adaptable detector for interpreting the cardinal movements of at least one muscle group of the hand during flexion, extension, or deviation of the wrist, or abduction, opposition, flexion or hyperextension of individual digits of the hand. The detector translates the movements of the muscle group into rotational data for the system and effectively isolates the movements of the muscle group so that the movements of other muscle groups of the body are not detected by the system. The system also includes a controlled resistance coupled to the detector which provides a variable resistance against the muscle group and ascertains the force applied to the detector by the movements of the one muscle group. The resistance can be varied to provide isotonic, isokinetic, or isometric modes of testing against said at least one muscle group.

NOTICE OF GOVERNMENT INTEREST

The United States government has a paid-up license in this invention andthe right in limited circumstances to require the patent owner tolicense others on reasonable terms as provided for by the terms ofContract Number NAS 9-18470 awarded by the National Aeronautics andSpace Administration.

LIMITED COPYRIGHT WAIVER

A portion of the disclosure of this patent document contains material towhich the claim of copyright protection is made. The copyright owner hasno objection to the facsimile reproduction by any person of the patentdocument or the patent disclosure, as it appears in the U.S. Patent andTrademark Office file or records, but reserves all other rightswhatsoever.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates to the training, evaluation, and retraining offactors that limit human performance. Specifically, the inventionrelates to a method and apparatus for training, evaluating andreconditioning the performance of the hand, wrist, forearm, elbow andshoulder.

2. Description of the Related Art

Rehabilitation specialists are often asked to conduct an assessment ofpatients that have acquired a limitation to their optimal independentactivity. Reconditioning or retraining of functional human performanceis also an important goal of rehabilitation.

Although the parameters of human performance vary widely, one mayidentify several principles which are common to all forms of independentactivity. Such common principles are muscular strength, endurance, jointrange of motion, and motor coordination. It is these parameters ofperformance that the rehabilitation specialist will focus upon. Thespecialist directs attention upon the identified parameter's which arelimiting performance and evaluates the degree of the limitation.

In the process of reconditioning, each of these principles will also bethe focus of attention. Each of them will be enhanced by retrainingtherapy. The underlying physiological adaptations responsible forperformance enhancement include, but not limited to, vascularity, cellbiochemistry and motor coordination skills.

The methods used in both the assessment and retraining process of themuscle groups are closely related. Both procedures physically tax oroverload the affected muscle group to quantify its performance and alsoto cause biological adaptations to improve the performance of thatmuscle group. Historically, the rehabilitation specialist will have ahands on approach using his own healthy limb to resist the movement ofthe patient's limb. In this way, the clinician evaluates the patient'sperformance through feel and, at the same time, offers exercise to thelimited muscle group. By repetitive, hands on, accommodating exercise,the limited muscle group is overloaded and adapts biologically withimproved performance.

For example, muscle strength is a performance parameter which is quiteplastic in quickly adapting to immobilization or disuse as well as toincreased activity or overuse. That is, muscle strength quite quicklyincreases or decreases with respect to use or disuse. Disuse, such asimmobilization following injury or casting after surgery, results in asignificant decrement in muscle size and hence muscle strength. Incontrast, if free weight lifting is used as the method of choice for therehabilitation therapy, the end result is a quick response of increasedmuscle cell size and hence gains in muscle strength.

Weight lifting equipment will overload a muscle group by using gravityagainst which a muscle must move the weight. With free weights, nocontrols are present to direct the speed of movement of the limb nor theresistance throughout the range of motion that the muscle must workagainst. The maximum free weight resistive load that can be applied to alimb is determined by the capacity of the associated muscle group asmeasured throughout the range of motion of the limb. The maximum loadthat the limb can support varies throughout its range of motion where atsome point it is at a minimum and at another it is at a maximum. Hence,the maximum resistive free weight load that can be applied is equal tothe maximum supportable load in the weakest area of the range of motion.

Conventional methods of subjective assessment and reconditioning, suchas subjective "through the clinician's hands" evaluations and freeweight exercise, are now reinforced with technology.

Technology has been developed which provides for assessment andreconditioning of muscular deficiencies by electronic control of therate of movement of the limb. This rate of movement control is achievedby constantly varying the amount of resistance offered the moving limbthroughout the range of motion. This category of devices are to allowthe muscle group, usually a whole limb or limb segment, to accelerate toa pre-selected speed. These constant speed devices use the methods ofisokinetic or accommodating resistance.

In the isokinetic system, once the moving limb achieves the selectedspeed, the device then offers the muscle group an accommodatingresistance which is proportional to the contractile force such that thelimb continues to move at the selected speed. These mechanisms usuallyhave some form of position/time feed back, servo loop which directs theresistance, for example, through feeding a variable current to a DCservo motor, to be such that, no matter what constantly varying force isexecuted by the contracting muscle group, the limb does not exceed orfall below the speed selected.

The goal with isokinetic systems is that throughout the entire range ofmotion of the limb, the associated muscle groups are working at theirutmost level while receiving an optimal overloading resistance.

The contractile effort of a muscle group against this type ofmicroprocessor based resistance is registered by the system and producesa profile of contractile performance which is widely recognized asaccurate and repeatable. The data from such a system can be used in acourt of law as evidence in disability claims.

Examples of such isokinetic systems are the Cybex, manufactured byLumex, U.S. Pat. No. 3,465,592, inventor J. Perrine; the LIDOmanufactured by Loredan, U.S. Pat. No. 4,601,468; inventor M. Bond, KINCOM manufactured by Chattanooga, U.S. Pat. No. 4,711,450, inventor J.McArther; the Biodex, U.S. Pat. No. 4,628,910, inventor R. Krukowski andU.S. Pat. No. 4,691,694, inventor R. Boyd, et al.; and the devicesdisclosed in U.S. Pat. Nos. 3,848,467 and 4,235,437. Each of thesesystems use the method of isokinetic resistive exercise/assessmentapplied to the large muscle groups of the legs particularly the knee.

Attachments are also available to modify these devices to address thearms and, secondarily, the ankle, wrist and hand. With respect to thehand, gross movements are allowed by these systems which include a.) anattachment which simulates the grip motion one would use with pliers andb.) an attachment which has a moving rod element with the forearmrigidly fixed for simulation of certain wrist activities. In each case aspecific work task is simulated with these accessories.

The shortcoming of these devices is that the movements described by thehand are those which are seen specifically at job sites or only rarelyin life. Reliability of the assessment data is questionable with thesesystems due to the inability to accurately reproduce the same postureand set up for each trial. These devices are best suited to exercisemuscle groups and areas of muscle groups. The assessment aspect of thesedevices is severely limited by the design.

Other devices have been developed with similar intentional designslimiting the use of the system to simulations of specific work tasks.For example, U.S. Pat. Nos. 4,337,050 and 4,768,783 issued toEngalitcheff, Jr. disclose a method and apparatus for rehabilitatinginjured muscles. Engalitcheff, Jr. teaches an apparatus which includes anumber of specific accessory elements simulating various tools coupledto a controlled resistance device. These accessories allow the therapyto address the particular work tasks an individual may be expected toperform. Each accessory element is specifically adapted to theresistance device, which includes a rotatable shaft, controlled, in oneembodiment, by an electric brake coupled to an adjustable voltagesource. Ostensibly, selective resistance is provided to each of thevariety of various accessories to permit exercise of specific muscles orjoints in simulated industrial applications. Feedback regarding theamount of force applied to each particular exercise is provided by avoltmeter; no other type of data feedback is provided.

A more sophisticated rehabilitation system which also includes means forevaluating muscle degradation is the LIDO® WorkSET, manufactured byLoredan Biomedical, Inc., Davis, Calif. The Loredan device includes anadjustable resistance head, to which a number of accessories may becoupled, and various other tool-type accessories for simulatingwork-related activities. The resistance head generally includes a gearreducing element and a D.C. servo motor, appropriately sized to provideresistance for the various tool accessories. A personal computercontrols the resistance applied to all accessories of the system,providing variable resistance to each of the accessories attachedthereto for a series of exercise and evaluation modes. The Loredansystem is capable of automatically implementing three general types ofexercise for a test subject: isokinetic, isotonic and isometricexercise. The isokinetic exercise mode generally provides a variableforce against the particular motion undertaken by subject with theexercise accessory to maintain a constant velocity on the test subject'saction. The isotonic exercise mode provides a constant force against thetest subject's actions to allow the subject to move the accessory deviceat varying speeds. The isometric exercise mode deals generally with thestatic measurement of the flexing and extension of particular muscles,including both concentric and eccentric contractions.

The Loredan system requires a physical floor space area of approximately8' by 8', generally making it suitable only for large scalerehabilitative efforts. The numerous attachments are adaptable to allowrehabilitation of many muscle groups in a manner similar to the of theEngalitcheff, Jr. devices.

Disuse atrophy, caused by such things as cast immobilization, results ina loss in human performance by negatively effecting muscular strength,endurance, joint range of motion, and motor coordination skills. Disusecan be a consequence of a variety of factors, including being forcedinto a bedridden condition following traumatic injury. Anothercircumstance that can bring about disuse atrophy is living in aweightless environment. Clearly, the degradation of muscular systems ofastronauts can have a deleterious effect not only on the success of anyparticular flight mission, but the basic safety of all members of theflight vehicle crew. As noted above, exercising particular muscle groupscan prevent muscle deterioration. Studies have shown that individualsexposed to simulated weightlessness who exercised daily were able tomaintain muscle strength in the particular muscles exercised. Inparticular, isokinetic exercise of particular muscle groups has beenfound clearly effective in maintaining muscle strength under conditionsof simulated weightlessness. Naturally, it would be desirable to provideastronauts on flight missions with the means to effectively exercisemuscles to maintain muscle strength, particularly in key muscle groups.

Physical space and astronaut time are at a premium on all space flightmissions. The machines discussed above are generally not suitable foruse on flight missions because of the physical space required for theireffective operation. For example, the Loredan device, while providing acomprehensive means to evaluate and recondition loss of performance, isprohibitively large to allow its use on, for example, the Space Shuttle.Further, it is not an effective device to use for hand movements havingthe basis of its design a focus on large arm movements such as using asteering wheel of an automobile.

Further, exercise suitable for maintaining muscular strength must imposesufficient force and inertia on the muscles under treatment to maintainthe muscular endurance of flight crews. One particular study hasadvocated the use of a treadmill; however, certification of such adevice for the stresses to which it will be exposed in space flight useis a major endeavor.

It is also critical to determine the extent of any damage or loss ofcontrol to muscular groups on spaceflight missions. One apparatus fortesting the strength and control of muscular systems of the hand isdisclosed in U.S. Pat. No. 4,885,687 issued to Carey. Carey discloses adevice which requires a test subject to trace a number of force patternsby altering the force of the subject's grip on a handgrip dynamometerand load cell. Carey provides a significant amount of quantitative datafor evaluation of the subject's performance on each of a number ofincreasingly difficult tests. However, Carey provides no significanttherapeutical means for improving the subject's performance. Further,Carey contemplates use of the subject's entire hand and is limited totesting contractile force of the basic hand grip. Thus, the dataprovided by Carey as to the condition of the muscles of the hand israther limited.

Thus, an object of the invention is to provide a system for thecomprehensive evaluation and correction of muscular systems of the humanbody.

A further object of the invention is to provide a comprehensive systemfor the evaluation and training of the human hand, wrist, elbow, andshoulder.

Yet another object of the invention is the provision of the aboveobjects within compact physical dimensions making the system suitablefor use on orbital vehicles.

Another object of the invention is to provide a evaluation and exercisesystem which is capable of testing and evaluating all cardinal movementsof the human hand, including the individual fingers thereof.

Yet another object of the present invention is the provision of a novelmeans for controlling a testing and evaluation system.

Another object of the present invention is the provision of the aboveobjects in a system which provides comprehensive, high resolutionfeedback to the control mechanism of the evaluation system, and alsoprovides comprehensive feedback on the condition of the muscle groupsunder test by the evaluation system.

A further object of the present invention is the provision of the aboveobjects in conjunction with an automatic software control system whichautomatically provides a series of testing and correction schemes.

A further object of the present invention is the provision of a controlsystem including control software which simulates a variety ofActivities of Daily Living (ADL) to measure the performance of the testsubject and train the muscular groups associated with each activity.

A still further object of the present invention is to provide a systemfor evaluating and training the muscular systems of the human body whichutilizes a unique ergonomic testing mechanism.

Yet another object of the invention is the provision of novel means forthe application of isokinetic loading against the motions of the handincluding the thumb and digits and upper extremity.

Yet another object of the invention is the application of isokineticloading methods in motor coordination skill assessment specificallyreaction time to mechanical movement and frequency of tapping/squeezemovements.

The present invention looks to applying the accepted methods ofisokinetic assessment and reconditioning to the function of the hand byisolating cardinal movements of the hand.

SUMMARY OF THE INVENTION

These and other objects are provided in a system for isolating,evaluating and exercising the muscle groups of the human hand.Generally, the system comprises means for detecting the cardinalmovements of the hand and translating the movements into rotational datafor the system, the means for detecting effectively isolating themovements of the hand so that the movements of other muscle groups ofthe body are not detected by the system. The system also generallyincludes means for providing a selective variable resistance to themeans for detecting and for ascertaining the force applied to the meansfor detecting by the movements of the hand.

The means for detecting may comprise a stationary element and arotational element mounted for rotation about an axis positionedadjacent the stationary element. The means for providing a selectiveresistance may comprise a magnetic particle resistance element coupledto a means for controlling the resistance to rotation of the rotationalelement when a force is applied to the rotational element by anindividual test subject, the means applying a variable or constantresistance to the rotational element.

The system may also include a sensor for sensing torque applied to therotational element by the test subject, and a detector for detecting therotational velocity and position of the rotatable element. A motor forpositioning the rotatable element, and a clutch for selectively couplingthe motor to the rotatable element may also be provided.

Preferably, the means for controlling comprises: a central processingunit providing control signals; a motor control system responsive to thesensor and detector and the central processing unit; a motor drivesystem coupled to the motor control system, the motor drive systemproviding drive current to the motor; a torque sensing system coupled tothe torque sensor providing an analog output of the force applied by thetest subject to the test element; an analog-to-digital converter,coupled to the torque sensing system and the central processing unit,providing digital signals to the central processing unit indicative ofthe torque applied by the test subject to the test element; first andsecond digital-to-analog converters providing a first and second analogoutputs responsive to the central processing unit, respectively; a brakedrive system coupled to the first digital-to analog converter and theelectromagnetic brake to provide drive current to the electromagneticbrake; a clutch drive system coupled to the second digital to analogconverter and the clutch to provide drive current to the clutch; andsoftware means for directing the central processing unit to control themotor control system, brake drive system and clutch drive system toprovide a series of test exercises to the test subject.

The present invention also includes novel attachments which isolatedefined simple movements of the hand, wrist, forearm and shoulder. Theattachments that are included offer unique isolation of movementpatterns and hence give the data collected a quantitative nature whichis not found in older systems.

The present invention addresses the posture of the subject during theassessment and reconditioning program and hence provides forreproducible quantitative data wherein the subject is seated with theshoulder adducted against his side which is generally the position ofchoice when injury is present and a pain induced protective posture istaken.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of one embodiment of the evaluation andtraining system of the present invention.

FIGS. 2 and 2A are front side views of the electromechanical componentsof the evaluation and training system of the present invention.

FIG. 3 is a top view of the stationary element and rotating elementcomprising the basic ergonomic configuration of the evaluation andtraining system of the present invention.

FIG. 4 is a perspective view of one embodiment of the evaluation andtraining system utilizing removable stationary and rotating postelements in the basic ergonomic configuration.

FIGS. 5 and 5A are perspective views showing the pinch measurementattachments for use in conjunction with the evaluation and trainingsystem of the present invention.

FIGS. 6 and 6A are perspective and top views showing the wrist rotationattachment and forearm support attachment for use in conjunction withthe evaluation and training system of the present invention.

FIGS. 7 and 7A are perspective views showing the forearm rotationattachment for use in conjunction with a evaluation and training devicewhich has been rotated approximately 85° in accordance with one aspectof the present invention.

FIGS. 8, 8A and 8B are side perspective and top views showing thebidirectional motion attachment for use in conjunction with theevaluation and training system of the present invention.

FIG. 9 is a block diagram of the electronic control system of thepresent invention.

FIG. 10 is a schematic diagram of the digital-to-analog converter,peripheral port controller, and a portion of the resistance element andclutch drive circuitry of the evaluation and training system of thepresent invention.

FIG. 11 is a schematic diagram of the motor controller utilized to drivethe d.c. motor of the evaluation and training system of the presentinvention.

FIG. 12 is a schematic diagram of a the motor drive circuitry and asecond portion of the clutch and resistance element drive circuitry ofthe evaluation and training system of the present invention.

FIG. 13 is a schematic diagram showing the analog-to-digital convertersof the evaluation and training system of the present invention.

FIG. 14 is a schematic diagram of the bridge amplifier utilized inaccordance with the torque transducer of the evaluation and trainingsystem of the present invention.

FIG. 15 is a schematic diagram of the watchdog circuit and interrupttimer of the evaluation and training system of the present invention.

FIG. 16 is a graph depicting the current vs. time when a voltage isapplied to either the magnetic particle clutch or magnetic particleresistance element of the evaluation and training device of the presentinvention.

FIG. 17 is a graph depicting the torque vs. the current applied to andby the resistance element of the evaluation and training device of thepresent invention.

FIG. 18 is a graph of the current vs. time for the magnetic particleresistance element and clutch of the present invention in accordancewith the novel control scheme of the present invention.

FIG. 19 is a flowchart of the main control software of the presentinvention.

FIG. 20 is a flowchart of the subroutine for initializing the extremerotational element stops of the evaluation and training system of thepresent invention.

FIG. 21 is a flowchart of the subroutine for initializing the exercisestop positions of the rotational element for individual test subjects inaccordance with the evaluation and training system of the presentinvention.

FIGS. 22a and 22b are a flowcharts of the subroutines for implementingthe isometric test mode of the evaluation and training system of thepresent invention.

FIGS. 23a and 23b are flowcharts of the subroutines for implementing theisotonic test mode of the evaluation and training system of the presentinvention.

FIGS. 24a and 24b are flowcharts of the subroutines for implementing theisokinetic test mode of the evaluation and training system of thepresent invention.

FIGS. 25a and 25b are flowcharts of the subroutines for implementing thereaction time test mode of the evaluation and training system of thepresent invention.

FIGS. 25a and 25b are flowcharts of the subroutines for implementing thereaction time test mode of the evaluation and training system of thepresent invention.

FIGS. 26a and 26b are flowcharts of the subroutines for implementing thetap response test mode of the evaluation and training system of thepresent invention.

FIGS. 27a and 27b are flowcharts of the subroutines for implementing thecontinuous passive motion mode of the evaluation and training system ofthe present invention.

FIG. 28 is a sample of the data printout of the physiological evaluationand exercise system of the present invention showing the isometric,isotonic, isokinetic and proprioceptive test data acquired by the systemfor a particular test subject.

DESCRIPTION OF THE PREFERRED EMBODIMENT

The present invention comprises a system for evaluating and training theperformance of the hand, wrist, forearm, elbow and shoulder. Theinvention provides a system which isolates the particular muscle groupsunder test with greater specificity than previously accomplished byprior art exercise systems.

Several specific unique features of the system serve to provideinventive aspects thereof. A unique ergonomic environment for testingand evaluating the performance parameters of the specific muscle groupsof the hand, wrist, forearm, elbow and shoulder is provided. In oneembodiment, the ergonomic environment comprises a basic configuration,including a rotating element and a stationary element. The rotatingelement positioned for rotation about an axis located adjacent astationary element. In other embodiments, a number of attachments makethe ergonomic environment adaptable to test various performanceparameters of each of the aforementioned muscle groups. In the baseergonomic configuration, the device is suitable for testing the cardinalmovements of the hand and fingers, including both flexion and extensionthereof. The attachments, discussed further below, provide more suitablemeans for testing portions of the wrist, forearm, elbow and shoulder, inaddition to specific muscle groups of the hand and individual fingers.

In general, the system operates by utilizing a passive resistanceelement coupled to the rotatable element and, in another feature uniqueto the system, the passive resistance element comprises a magneticparticle resistance element which allows for a variable, microprocessorcontrolled resistance to be applied to the rotating element in a varietyof evaluation modes. Use of the magnetic particle resistance element asthe passive resistance element allows for a downsizing of the evaluationand training system with respect to those physical therapy systemsdiscussed in the Background section. As such, the evaluation andtraining system of the present invention may be provided in a number ofvarious physical packaging schemes, including: an embodiment suitablefor use on the United States Space Shuttle, for the training andevaluation of the condition of astronauts; a small form factor, portableunit suitable for use in field testing of workers' compensation claims;and an integrated, carriage built system, such as is shown in FIG. 1,for hospitals or physical therapy facilities. As illustrated in FIG. 1,the carriage system includes facilities for the close range positioningof keyboard 205, monitor 210, and printer 207.

The system also utilizes a novel, computer controlled, test mode controlsystem, providing output data on the condition of an individual testsubject's physical condition. A unique electronic control system isprovided in the system to allow the computer to accurately control theelectromechanical elements of the present invention. In addition, aunique method of programing the master and slave microprocessorsutilized in the control electronics is incorporated in the evaluationand training system of the present invention. All of the above featuresare provided in a configuration which, when included with the specifictechnical performance parameters of the system, yields a highlyefficient, improved physical exercise and evaluation system.

As noted above, FIG. 1 is a perspective view of one embodiment of thephysiological evaluation and training system of the present invention.Shown therein is a basic ergonomic configuration suitable forimplementing a number of test modes, comprising rotatable element 10 andstationary element 15. As shown generally in FIG. 1, element 10 rotatesabout an axis 12 adjacent stationary element 15.

The electromechanical elements of the system allow for the basicergonomic configuration to translate the spiral motion of the hand intorotational data for the control system of the device therebyfacilitating measurement by the microprocessor-based control system,discussed in detail below. By adjusting the angle of the device (or axis12) relative to the test subject, and/or utilizing the attachmentsdiscussed below, the device is capable of measuring the performance of:flexion and extension of the fingers; flexion and extension of thewrist; circumduction, abduction, and adduction of the wrist with fingersextended or flexed; partial complex movement; of the thumb; certaintypes of basic grasp; supination and pronation of the forearm; andinternal and external rotation of the shoulder.

As shown in FIGS. 1 and 2, rotating element 10 is coupled to main shaft18 by arm 16. Main shaft 18 is rotatable about axis 12 in like manner asrotating post 10. Axis 12 is positioned adjacent stationary element 15and it may be appreciated that the evaluation and training system may beutilized with the vast number of various human hand sizes by varying therotational position of rotational element 10 relative to shaft 15. Thatis, as shown in FIG. 3, by adjusting the linear distance D betweenrotating post 10 and stationary post 15, any number of various sizedhands can be evaluated and trained with the system using the basicergonomic configuration.

In operation, a particular subject will be directed to place his handabout rotational element 10 and stationary element 15 in a manner asshown in FIG. 3, with the fingertips positioned about rotating element10 and the thumb about stationary post 15. The particular positioning ofrotational element is generally limited to between 0°-180° for a righthand test and 180°-360° for a left hand test. As will be discussedfurther below, movement of element 10 is limited to preset stoppositions based on the particular linear distance D suitable for thehand size of the particular test subject. Using the basic ergonomicconfiguration in this manner, isokinetic, isotonic, isometric andproprioceptive tests may be performed.

In the isokinetic test, the test subject will be directed to contracthis hand so as to reduce the distance between rotating element 10 andstationary element 15. During this action, the evaluation and trainingsystem will continuously measure the torque translated to the shaft 18by the force exerted by the test subject on element 10 and provide avariable resistance against the rotation of element 10 such that thespeed at which element 10 rotates about axis 12 remains essentiallyconstant. Generally, the test is repeated a number of times to provide astatistically valid measurement of the force applied to element 10 bythe test subject. Over a series of measurements, the variation in theforce applied by the test subject to element 10 can be useful indetermining whether the subject is intentionally attempting to deceivethe device by, for example, not applying a full rotational force onelement 10 during each repetition of the test, which may be indicativeof false claims of debilitation.

In the isotonic test mode, the test subject will again be directed toplace his hand in a manner as shown in FIG. 3 about rotational element10 and stationary element 15. The device will thereafter measure thetorque on the main shaft 18 and vary the resistance to rotation of theshaft so that the force applied by the test subject is not greater thanthe isotonic force selected.

In the isometric mode, the system will apply a maximum resistanceagainst rotating element 10, to an extent such a test subject willgenerally be unable to move element 10 towards element 15. Again, whenprompted, the test subject will be directed to contract his or her handin an attempt to move element 10 toward element 15 by contractinghis/her hand. The torque translated to the shaft 18 by the force exertedon element 10 by the test subject will be measured by the system.

In a proprioceptive test, the test subject's reaction to stimuli fromthe rotational element is measured. In a "reaction time" test, element10 will be moved to a preselected position at a suitable distance Dselected relative to the size of the individual's hand being tested.When the test begins, rotational element 10 will move in acounterclockwise direction (for the right hand) and the individual testsubject will be directed to follow element 10, maintaining lightpressure thereon. At a random position, the system will rapidly reversethe direction of element 10 so as to move it in the clockwise direction,and the test subject will be directed to contract his/her hand, movingelement 10 toward the 0° position, once the direction reversal ofelement 10 is felt. Ideally, the test subject should not be able tovisually detect the reverse direction of element 10. An alternativeproprioceptive test, is the "tap" response test, requiring quick,successive contractions of the hand of the test subject, with the testobjective being to detect the time between contractions.

In both the basic ergonomic configuration, and when using the particularattachments discussed below, the physiological evaluation and trainingdevice of the present invention provides the only known means availablefor isolating cardinal movements of the hand. Specifically, the deviceof the present invention requires that the shoulder be adducted to thebody to prevent the test subject from incorporating other musculargroups into the test, thereby potentially yielding test results whichare not indicative of the true state of the muscular group under test.For example, using the Loredan LIDO® WorkSET device, discussed above inthe Background section, a test subject using the hand attachment may beable to use other parts of the body including different muscle groupsthan those the device is designed to test, to assist in providing thelinear motion incorporated by the WorkSET hand attachment. In the basicergonomic system of the present invention, prehension patterns of thehand are isolated by the rotational and stationary test elements, andthe specific attachments of the system, specifically requiring themuscles of the hand to be utilized, thereby isolating the muscles of thehand which are under test and providing more precise test results.

FIG. 2 is a block diagram showing the main electromechanical componentsof the evaluation and training system of the present invention. Thebasic ergonomic configuration of rotating element 10 and stationaryelement 15 is shown for explanation purposes. It should be understoodthat the operation of the electromechanical elements of the evaluationand training system is the same whether the basic ergonomic system isimplemented or whether the various attachments for the specific testingof particular muscle group functions are utilized. The electromechanicalelements of the evaluation and training system of the present inventioninclude torque sensor 20, magnetic particle variable resistance element22, rotary optical encoder 24, magnetic particle clutch 26, and motor28. Each of the aforementioned elements, with the exception of motor 28,is mounted to a main shaft 18 provided in a casing such as, for example,that shown in FIGS. 1 or 2.

The electromechanical elements used in the system will be hereinafter bedescribed in relation to their operation in effecting the specific testmodes discussed above. The evaluation and testing system of the presentinvention is essentially a passive resistance system wherein, duringmost evaluation sequences, no active resistance is utilized. The mainpassive resistance element is magnetic particle resistance element 22. Amagnetic particle element such as Model B150, available from PlacidIndustries, Inc., Lake Placed, N.Y., having a torque rating of150-inch-lbs., with a maximum torque of 250-inch-lbs., is suitable foruse in the system. Magnetic particle resistance 22 is selected for usein the present invention because of its ability to provide asignificantly high amount of torque (i.e., 250-inch-lbs.) with no activemoving mechanical parts, thereby providing smooth resistive operation,free of backlash, for rotational element 10. The resistive torqueresponse of magnetic particle resistance element 22 is also preciselycontrollable. In the present embodiment, electronic control circuitry inconjunction with a computer controlled, pulse width modulated currentmode drive is utilized to provide a variable torque in opposition to therotation of rotational element 10. A unique feature of magnetic particleresistance element 22 is the fact that the output, coupled to main shaft18, does not engage housing 23 of magnetic particle resistance element22. Housing 23 is filled with a fine, dry stainless steel powder whichis free flowing until a magnetic field is applied from a stationary coilwithin the housing 23. The torque resistance is proportional to themagnetic field and thus the applied DC input current.

The resistance element 22 is coupled by main shaft 18 to a torque sensor20. Torque sensor 20 is a conventional torque sensor and may comprise,for example, a Model TRT-200 available from Transducer Techniques, Inc.,Temecula, Calif., capable of measuring up to 200-inch-lbs. of torquewith a resolution which allows it to resolve forces applied to element10 to a resolution of 225 grams (0.5 lbs.).

Optical encoder 24, coupled to shaft 18, is utilized by the system fordetermining the position, between 0°-360°, of rotational element 10.Optical encoder 24 is a standard optical encoder, such as ModelLD23-DM-2500-5LD-1B, available from Lucas Ledex Corporation, capable ofa resolution of at least 25 counts per degree of motion (2500 linecounts per 360° measurement). As will be explained in further detailbelow, the control system of the present invention multiplies the outputof the optical encoder in quadrature, thus providing a total of 5000data samples per 180° motion by a particular individual test subject. Inan alternate embodiment, appropriate gearing or belt coupling can beutilized between shaft 18 and encoder 24 to increase the number ofcounts per revolution.

Magnetic particle clutch 26 is provided to selectively couple motor 28to shaft 18. Clutch 26 includes input shaft 27₁ and output shaft 27₂.Input shaft 27₁ is coupled to motor 28, while output shaft 27₂ iscoupled to shaft 18. Clutch 26 may be a Model C25 magnetic particleclutch, also available from Placed Industries, Inc., supra. Clutch 26has a maximum torque of 25-inch-lbs. and couples input shaft 27₁ tooutput shaft 27₂ when electric current is applied thereto. Clutch 26operates on the same principles as magnetic resistance element 22, butis generally utilized in a "full on" or "full off" mode. In addition,whereas main shaft 18 is not coupled to housing 23 of magnetic particleresistance element 22, housing 29 of clutch 26 is not coupled to inputshaft 27₁ or output shaft 27₂.

Output shaft 27₂ of clutch 26 is coupled to a D.C. gearhead motor 28,capable of approximately 30 rpm, an applied force of 25-inch-lbs., andhaving an output power of approximately 1/50 horsepower. Motor 28 maycomprise Model GPP1009 available from Baldor/Boehm, Fort Smith, Ark.

As noted above, the aforementioned test modes utilized for a particularindividual test subject are performed using magnetic particle resistanceelement 22 as the main resistance element of the system to providecontrolled resistance on shaft 18, and thus rotational element 10. Motor28 serves primarily to position element 10 at any point along its 360°rotational travel path as shown in FIG. 3, and provides no appreciableresistance to element 10 during isometric, isotonic or isokinetic tests.Magnetic particle clutch 26 serves to sever main shaft 18 from DC gearhead motor 28.

However, during the constant passive motion (CPM) mode, motor 28 isutilized to direct the motion of element 10 responsive to the particularcontrol program implemented by the control system. During this mode,motor 28 supplies the force of movement of element 10, and motor 28effectively guides movement of the patient's hand, or other appendage.In addition, in one proprioceptive test mode, motor 28 is utilized toposition element 10 at a preselected location, is thereafter directed torotate the element for a random amount of time in a clockwise orcounterclockwise direction, (depending on the particular hand undertest), and to selectively reverse the direction of element 10 at aparticular point in time to test the reaction time of the test subject.It should be noted that once the reverse direction operation iscompleted by the motor (the element is reversed in direction for amaximum of 25°), clutch 26 disengages the motor. Thus, in CPM mode,motor 28 does effectively provide some resistance to the test subject byguiding movement of the subject's hand. However, during the isometric,isokinetic, isotonic, and tapping test modes, motor 28 merely acts toposition element 10 at a preselected test point in its 360° rotation andresistance is thereafter supplied by magnetic particle resistanceelement 22.

Operation of the aforementioned electromechanical elements is discussedbelow with respect to the detailed discussion of the electronic controlsystem. One key feature of the aforementioned electromechanicalelements, and particularly the magnetic particle resistance element, isthat these components occupy a relatively small form factor comparedwith prior art systems. For example, the configuration shown in FIG. 2may be provided within a physical casing 30 having a height H of 12", alength L of 6" and a width W of 6". By removing motor 28, andpositioning rotational element 10 solely by hand, the form factor of thesystem may be reduced even further.

As noted above, the evaluation and training system of the presentinvention includes a number of adaptive attachments which augment thebasic ergonomic environment of elements 10 and 12 with devices which arespecifically adapted to allow for ease in testing particular motions ofthe hand, wrist, forearm, elbow and shoulder. As noted above, the basicconfiguration of element 10 and element 12 is suitable for any number ofapplications in isolating the particular movements of the hand andfingers.

FIG. 4 shows one embodiment of arm 16 used to couple rotating element 10to main shaft 18. Arm 16 includes a first and second ends 16₁ and 16₂ onopposite sides of axis 12. First bore 17 (FIG. 5A) is provided on firstend 16₁ of arm 16. Second end 16₂ includes a cup (not shown) in which abearing (not shown) is inserted. The bearing includes an inner bore 19(FIG. 6) for receiving various rotational attachments therein. Bores 17and 19 are included on arm 16 to allow the various different attachmentsto be quickly interchanged in the testing sequence of the system of thepresent invention.

Also shown in FIG. 4 is rotating element 10 suitable for use inconjunction with arm 16. Post 10 has a diameter which is suitable toallow post 10 to be received in bearing bore 19 of arm 16. Element 10may include, for example, a foam rubber sleeve 11, positionedthereabout, to provide comfort to the test subject when engaged invarious tests. As shown in FIG. 5A in one embodiment of the invention,the upper cover surface 32 of casing 30 has two bores 32₁ and 32₂ (FIG.6) positioned therein, which are utilized to receive fixed elementattachments for use in conjunction with the system of the presentinvention.

As shown in FIGS. 2A and 4, one embodiment of stationary element 15 ofthe present invention is adapted to be received and mountable in bores32₁ and 32₂ and casing 30. Stationary post 15 may also include a foamrubber sleeve 11 similar to that used with rotating element 10.Stationary post 15 is preferably cast molded to include a base member34, having two mounting members 36₁ and 36₂ which are adapted to bereceived into bores 32₁ and 32₂, respectively. Mounting members 36₁, 36₂are offset from post 15 by a specified distance. It should be understoodthat this offset is not required, but is utilized in the presentinvention to allow post 15 to be as close as possible to the rotationalpath of rotating element 10 while providing ease in adapting otherstationary attachments for use with the evaluation and training systemof the present invention. Generally, arm 16 and the electromechanicalcomponents of the system are covered by plate 38.

FIGS. 5 and 5A are perspective, and exploded perspective views,respectively, showing pinch test attachment accessories suitable for usein testing each of the individual fingers of the hand with respect topinching movement in opposition to the thumb. The accessories shown inFIGS. 5 and 5A are designed to allow for the pinching motion of each ofthe test subject's fingers in opposition to the thumb to be tested. Inapplying these particular attachments, stationary post 15 and rotatingpost 10 are removed from respective bores 19, 32₁, 32₂. The pinchattachment accessories include an adaption plate 40 to provide astationary element in the pinch testing configuration at a positionwhich is 180° opposite the location of stationary element 15 in thebasic ergonomic configuration. Adaption plate 40 includes first andsecond mounting members 41₁ and 41₂ which are adapted to be inserted inbores 32₁ and 32₂ of the casing cover 32. Adaption plate 40 includes astationary mount post 43, utilized for mounting a curved stationaryelement 44. Element 44 includes cavity 44, which is sized to allowelement 44 to slide over post 43. A threaded bore 43₁ is provided inpost 43 so that a set screw may be utilized to secure element 44 ontopost 43. Rotating element 47 includes a curved region similar to that ofstationary element 44 and is designed to be insertable in bore 19 of arm16. As shown in FIG. 5, elements 44 and 47 allow for the comfortableplacement of the finger and thumb, respectively, for testing the pinchmotion with respect to individual digits of the test subject's hand. Itshould be understood that each of the aforementioned modes ofoperation--isotonic, isokinetic, isometric and proprioceptive--can beutilized to test the pinch strength of the test subject between twopoints in the manner as described above simply by adjusting the presetexercise points of rotating element 47. While it will be readilyincluded that pinch measurements could be performed using the basicergonomic configuration, the pinch attachments (adaption plate 40,element 47 and element 44) are more effective at isolating the motion tothe muscle groups being tested.

FIGS. 6 and 6A show accessory attachments which are adapted for use inconjunction with the testing of the rotative motion of the wrist.Accessory 60 comprises a handle portion 61 mounted via frame member 62to a mounting post 63. Mounting post 76 is adapted for insertion intofirst bore 19 of arm 16. Accessory 60 is used in conjunction withforearm support accessory 65 which comprises a metal trough 66, havingan interior insert of foam padding 67, in which a forearm of the testsubject may rest when using the wrist accessory 60. Straps 68 areprovided to secure the forearm of the test subject in the forearmsupport 65. Mounting posts 66₁ and 66₂ are secured to trough 66 and areadapted for insertion in bores 32₁ and 32₂ of casing 32 to secureaccessory 65 to casing 32. As shown in FIG. 6A, the forearm support 65and wrist accessory 60 allow for testing of the radial/ulnar deviationof the test subject. A test subject's forearm is supported in supportmember 65 while the subject is instructed to grip handle 61. In thismanner, isometric, isotonic, isokinetic and proprioceptive testing ofthe wrist may be effected.

Forearm support 65 may also be used in conjunction with rotationalelement 10 for testing flexion and extension of the wrist. In the wristflexion and extension testing, the subject's right arm (shown in FIG.6A) would be rotated 90° counterclockwise in forearm support 65.Rotating element 10 would replace accessory handle 60, with thesubject's fist fully closing about element 10.

In FIG. 7, forearm test accessory 70 is shown for adapting the testingand evaluation system to test supination and pronation of the forearm.Forearm attachment 70 comprises handle 71 mounted to frame 72 havingmounting members 73 and 74 projecting therefrom. Members 73 and 74 areadapted to be received in bore 19 and bore 17, respectively, of arm 16.Forearm attachment 70 requires that arm 16, and the electromechanicalcomponents of the system attached thereto, be rotated slightly less than90° (approximately 85°) (see arrow 75) so that rotational axis 12 isroughly parallel to the ground. As shown in FIG. 7A, this allows a testsubject to be seated adjacent the test system, with the shoulderadducted to the body, with rotational axis 12 extending through theforearm of the test subject. The subject's forearm is then rotatedclockwise and counterclockwise to evaluate forearm strength using any ofthe test modes discussed herein.

FIG. 8 shows an alternative embodiment of rotational element 10 for usein conjunction with the continuous passive motion (CPM) mode, as well asthe aforementioned mode, of the evaluation and training system of thepresent invention. As shown in FIG. 8A, individual fingers 89 of thetest subject's hand are secured to grip rotation element 80 to allow therange of motion directed by the CPM mode of the evaluation and trainingsystem to be translated into the test subject's hand. As shown in FIGS.8 and 8A, element 80 comprises a metal, vertical rotation element 80,including a mounting post 82 adapted to be receivable in bore 19 on arm16. Element 81 is comprised of a rectangular shaped finger havingnotches 83₁ and 83₂ formed therein on respective opposite sides offinger 81. D-shaped elements 85 are manufactured to be receivable ingrooves 83₁ and 83₂ to secure a nylon ribbon 86 about the fingers of thetest subject. Approximately four (4) D-shaped elements 85 are provided.One end of ribbon 86 may be secured, for example, by a set screw 84provided at the base of element 80, as shown in FIG. 8A. Cap 87 may besecured to post 80 by a set screw 87₁ provided in threaded bore 88 inelement 81. The top end of ribbon 86 may be wrapped over the top of cap87 and attached by a loop and hook fastener to the back side of element80. In CPM operation, as shown in FIGS. 8A and 8B, a test subject willplace each individual finger between the D-shaped elements 85 andmounted on element 81 and the fingers will thereafter be secured bynylon ribbon 86. The control system of the present invention willthereafter move rotational element 80 through a pre-programmedrotational sequence. In accordance with the objectives of the CPM mode,the system will thereafter supervise the movement of the test subject'shand between preset selected positions within the 360° range of motionof moveable element 10. The CPM sequence may be repeated any number oftimes in accordance with the therapy objectives for the patient. Theaccessory post shown in FIGS. 8 and 8A can also be used to isolate asingle finger for exercise or evaluation.

FIG. 9 is a block diagram of the electronic control system forinterfacing to the mechanical components of the evaluation and testingsystem of the present invention. As shown in FIG. 9, the control systemof the present invention includes computer 180, motor controller 100,motor driver circuitry 110, clutch driver circuitry 114, resistanceelement driver circuitry 112, two digital-to-analog converters 120₁,120₂, a bridge amplifier 150, analog-to-digital converter 140, andinterrupt timer and watchdog circuit 160. Motor controller 100 providesa voltage mode, pulse-width modulated signal output to motor drivercircuitry 110, and can detect the rotational position of element 10 fromrotary optical encoder 24. Personal computer 180, such as an Intel 83086microprocessor-based personal computer or equivalent, is utilized toprogram input to motor controller 100, DAC's 120, and interrupt timer160. A display monitor 210 and keyboard 205 may be attached to computer180 to provide a user interface therefore. Preferably, motor controller100, drivers 110, 112, and 114, converters 120, converter 140, andtorque sensor bridge amplifier 150, are all provided on a full slotplug-in expansion board in computer 180. As should be understood by oneskilled in the art, keyboard 205 and display monitor 210 may beimplemented using a touch screen interface system to simplify theinteraction process between the test subject/patient and the system.

Computer 180 also reads position input from encoder 24 throughcontroller 100 to dynamically control the resistance in the variousmodes of system operation. Two digital analog converters 120₁ and 120₂are coupled to resistance element drive circuitry 112 and clutch drivecircuitry 114, respectively. DAC's 120₁, 120₂ provide a current mode,pulse-width modulated output to clutch drive circuitry 114 andresistance element drive circuitry 112 to control the resistance element22 and clutch 26. The output of torque sensor 20 is provided to bridgeamplifier 150, having its output coupled to analog-to-digital converter140, to provide data on torque translated to shaft 18 by the forceapplied to element 10 directly to computer 180. Interrupt timer andwatchdog circuit 160 acts as a status monitor for the control systemsoftware, disabling the control circuitry when board access by thesoftware does not occur at regular intervals, and provides the timingsignals for the pulse-width modulated controllers and processorinterrupts of the system. The specific implementation of the controlsystem of the present invention are hereafter discussed with respect toFIGS. 10-15. The processes embodied in the control software utilized tocontrol the electronics of the system will be discussed with respect toFIGS. 19-27.

FIGS. 10 and 11 are schematic diagrams detailing the configuration ofmotor controller 100. As noted above, motor controller 100 provides avoltage mode, pulse-width modulated output to motor driver circuitry 110to control the velocity, direction, and position of motor 28. Motorcontroller 100 includes peripheral port controller 102 (FIG. 10) (type82C55A) coupled to both the internal data bus and address bus (XP) ofcomputer 180 to allow selective read/write of any of three different8-bit ports (PA0-PA7, PB0-PB7, PC0-PC7). Programmable-array-logic device103 (type 22V10) is included in motor controller 100 to provide selectedcontrol signals for other components of controller 100, and statusindicators to computer 180. Controller 100 also includes: a dedicatedmotor control slave processor 105, such as a HCTL1100, available fromHewlett-Packard Corporation, for driving the PWM control output of motorcontroller 100; a 2-4 decoder 106, such as a type 74ALS139, forgenerating chip select signals; and two tri-state buffers 107 and 108,such as 74ALS245 for allowing interruption and read/write betweenprocessor 105 and computer 180.

At system power-up or watchdog reset, port A will initially be an inputprot with all inputs pulled to a logic high level with resistor array104. The high levels on these lines will disable all control circuitry,thus putting the system in a "safe" state.

At system initialization, port A of peripheral port controller 102 isselected as an output port to drive all outputs thereof low, therebyenabling the resistance element and clutch drivers (PA0, PA1), HCTL₋₋STOP (enabling processor 105), MOTOR₋₋ DISABLE (enabling motor drivercircuitry 100), HCTL₋₋ RST (disabling the reset of processor 105),HCTL₋₋ LIMIT (disabling the LIMIT pin on processor 105), all havinglogic level high output via inverters U2C-U2F, and signals IR2QENA(enabling interrupt driver) and CAL (enabling the calibration resistorof bridge amplifier 150), having logic level high output.

Port B is generally selected by computer 180 to read various statesignals of the devices used in the electronic control system. Port Callows computer 200 to read the timing chips reset signal (8255₋₋ RST)and to output enable the clockwise and counterclockwise driver (CW₋₋ENABLE and CCW₋₋ ENABLE) signals to motor driver circuitry 110.

Processor 105 occupies 64 locations in the input/output address spaceand includes its own onboard slave microprocessor for controlling motorcontrol output signals (SIGN and PULSE) driving the motor drivercircuitry 110. Motor control processor 105 is coupled to the address anddata buses of computer 200 to allow processor 105 to be selectivelyprogrammed by computer 180 in response to the particular softwareoperation modes implemented for each test sequences. Processor 105directs the SIGN and PULSE outputs to provide a current steering throughH-bridge 115₁ (FIG. 12) through AND gates 109₁ and 109₂, and OR gates111₁ and 111₂. As shown in FIG. 12, the four motor driver signals MOT₋₋A+-MOT₋₋ D+ drive H-bridge 115₁ comprised of four power MOSFETs 116₁-116₄ to provide the pulse width modulated (PWM) voltage output formotor 28. As shown in FIG. 11, the SIGN output is coupled to AND gate109₁ and OR gate 111₂, and the inverted SIGN output, via inverter U2B,is coupled to AND gate 109₂ and OR gate 111₁. The PULSE output is gated,via NAND gate 101, with the MOTOR₋₋ DISABLE control signal fromperipheral port controller 102, and the output of NAND gate 101 iscoupled to OR gates 111₁ and 111₂. By selectively addressing processor105 and programming its onboard microprocessor, motor 28 may becontrolled to position rotating element 10 in either the clockwise orcounterclockwise direction at any point within the 360° rotationalpositions shown in FIG. 3. The registers of processor 105 can storecommand position, read and preset actual position, velocity set points,command velocity, acceleration, final position, and actual velocity formotor 28. Position data is acquired through the CHA, CHB inputs, whoseinputs comprise the CHANNEL A, CHANNEL B data from optical encoder 24.The CHA, CHB inputs are quadrature detected, thereby providing aposition resolution of 10,000 samples per 360°. The PWM output ofprocessor 105 is timed via an external clock (HCTLCLK) driven byinterrupt timer and watchdog circuit 160.

Because processor 105 is executing its own program, reading of theregisters therein requires interruption of the program running inprocessor 105 and transfer of the data in its internal registers to anoutput buffer. As shown in FIG. 11, tri-state buffer 107 is utilized ina unidirectional fashion (DIR wired to +5 v) to address processor 105.Buffer 108 is used to read and write data out of processor 105. During aread of processor 105, the internal program is interrupted, the internaldata register read, and the data therein placed in output buffer 108.The time required for this depends on the clock rate programed viatiming chip 162 (FIG. 15) of timer circuit 160. Typically, HCTLCLK isbetween 2 megahertz and 100 kilohertz. Normally, HCTLCLK is at 1megahertz. To prevent the system ready signal (I/O CH RDY/) from beinginactive for an excessive period of time while processor 105 is beingread, a two-step read process is used. Generally, the register addressis strobed to processor 105 via buffer 107. PLD 103 generates statuslines HCTLSTATE and HCTLWAIT which can be read by the CPU of computer180 before proceeding with the second step of the read. The equationsfor PLD 103 are set out in Appendix B. When the status indicates thatthe data is ready, the data can be read by executing an I/O readoperation from any register in the HCTL1100. A write to processor 105 isperformed in a single operation by writing to the desired I/O address.However, there is a minimum time required between consecutive writeoperations due to the clocking cycle of HCTLCLK. Normally this cyclingwill not be a problem; however, if the clock rate is slow, status linesHCTLSTATE and HCTLWAIT may be checked before proceeding.

A typical command control sequence will first involve setting the sampletimer to determine the sampling rate for the internal position controlloop of processor 105. Next, the SIGN output reversal inhibit is set toensure that no extra electronic noise is generated while the motor isunder the control of processor 105. Since processor 105 implements adigital filter on the error signal, the digital filter parameters mustbe set according to the transfer function provided for the filter. Next,the actual position of rotational element 10 must be set. As will benoted below, this is done, in one embodiment, by initializing the indexor "extreme" stops for element 10. The next input is to set the commandposition, which initially should be set to the same value as the actualposition. Finally, the execute program mode is set. After entering thecontrol mode, values can be written to the command position register. Ifthe clutch is engaged and the resistance element disengaged, the handlewill move to the commanded position unless resisted by the user.

Specific aspects of motor drive circuitry 110 will be discussed withreference to FIGS. 11 and 12. As will be understood by those skilled inthe art, if the MOTOR₋₋ DISABLE signal input to NAND gate 101 is logiclevel high, the PULSE output of processor 105 will be directed to steerH-bridge 115₁ by the SIGN output of processor 105. The clockwise enable(CW₋₋ ENABLE) and counterclockwise enable (CCW₋₋ ENABLE) outputs ofperipheral port controller 102 are provided to AND gates 109₁ and 109₂.As will be understood from an examination of the coupling of the SIGNoutput, and CCW₋₋ ENABLE and CW₋₋ ENABLE signals, the output of ANDgates 109₁ and 109₂, and OR gates 111₁ and 111₂, is such that a logiclevel high on either CW₋₋ ENABLE or CCW₋₋ ENABLE will enable the outputof AND gate 109₁ or 109₂, thereby driving photoactive transistors 92₁ or92₂. Transistors 92₁ and 92₂, in turn, steer power MOSFETs 116₁ or 116₂by enabling a current path for the 48 volt DC input coupled to therespective source electrodes of transistors 116₁ and 116₂. Similarly,the PULSE signal is directed to OR gates 111₁ and 111₂ by the SIGNsignal output and the inverted SIGN signal output (via inverter U2.B)coupled, respectively, to OR gates 111₂ and 111₁. The outputs of ORgates 111₁ and 111₂ in turn drive photoactive transistors 92₃ and 92₄ tosteer current through power MOSFETs 116₃ and 116₄, each having a sourcecoupled to ground and a drain coupled to the drains of transistors 116₁and 116₂, respectively. The PWM duty cycle of the PULSE signal willdetermine the velocity of rotational element 10. MOSFET 116₄ isactivated by a 2-state NAND gate U1, having a 15 volt output coupled tothe gate of MOSFET 116₄, MOSFET 116₃ has its gate coupled to the 15 voltoutput of NAND gate U6.

Certain aspects of resistance element drive circuitry 112 and clutchdrive circuitry 114 will be discussed hereafter with respect to FIGS. 10and 12. Resistance element drive circuitry 112 and clutch drivecircuitry 114 are somewhat similar to the motor drive circuitry 110, butare controlled by a dual output digital analog converter 121 having,effectively, two digital-to-analog converters 120₁, 120₂, shown in FIG.10. The DAC converter chip 121 may comprise, for example, an AD7528-typeanalog-to-digital converter, having an 8-bit data input coupled to theinternal data bus of computer 180 and being selectively addressable viathe address bus XP of computer 180. Digital analog converters 120₁, 120₂are used to set the current, and thus the resistance, of both resistanceelement 22 and clutch 26. The output of each DAC drives a current mode,pulse-width-modulated amplifier with linear, unipolar signalscorresponding to 1.66 amps full scale or 6.5 milliamps per leastsignificant bit.

As noted above, port A outputs PA0 and PA1 of peripheral controller 102are gated with the PWM current outputs through OR gates U21D and U21.Cto enable the BRAKE± and CLUTCH± drive outputs. Flip flops U22a and U22bare clocked by the PWM₋₋ CLK signal provided by interrupt timer andwatchdog circuit 160. Thus, BRAKE± and CLUTCH± provide the drive forresistance element drive circuitry 112 and clutch drive circuitry 114 ina PWM mode to regulate the current output to magnetic particleresistance element 22 and clutch 26, thereby regulating the resistancethereof. As will be generally understood, the output of DAC 120₁, 120₂provide a generally linear relationship between its output and theapplied resistance of resistance element and clutch.

The BRAKE+ and BRAKE- outputs drive photoactive transistor 92₅ tocontrol H-bridge 115₃ comprised of MOSFETS 118₁ -118₄, to supply currentat the BRAKE₋₋ A and BRAKE₋₋ B outputs to drive resistance element 22. A24 volt DC voltage is coupled to the respective drain electrodes oftransistors 118₁ and 118₂, the sources of transistors 118₃ and 118₄ arecoupled to ground and the drains of 118₁ and 118₃, and 118₂ and 118₄ arecoupled together. The gates of transistor and 118₂ is coupled to the 24volt DC rail and transistor 118₃ has a gate coupled to ground to allowtransistors 118₁ and 118₄ to steer current through the H-bridge tocontrol resistance element 22. The 15 volt DC output of two state NANDgate U2 is coupled to the gates of transistor 118₄ while the gate oftransistor 118₁ is coupled to bipolar transistor Q₃, whose base iscontrolled by photoactive transistor 92₅. Likewise, clutch signalsCLUTCH+ and CLUTCH- control photoactive transistor 92₆ where outputcontrols transistor 117₁ of H-bridge 115₂. Transistors 117₁ -117₄ ofH-bridge 115₂ are coupled in the same manner as transistors 118₁ -118₄.In most modes, clutch 26 will be used in a full-on/full-off mode whereits main purpose is to decouple motor 22 from main shaft 18. The clutchtorque is not calibrated, but the output of DAC 120₂ drives clutch drivecircuitry 114 at 1.67 amps which provides a "full on" torque of 40inch-lbs.

Signals BRK₋₋ CUR₋₋ REF, BRK₋₋ CUR₋₋ SEN; CLH₋₋ CUR₋₋ REF, CLH₋₋ CUR₋₋SEN) are provided to sense the drive current provided by H-bridges 115₃and 115₂, respectively. Current output feedback signals of theresistance element BRK₋₋ CUR₋₋ SEN and clutch CLH₋₋ CUR₋₋ SEN arecompared with the outputs of DAC 120₁, 120₂ by comparators U25a andU25b, respectively, which preset flip flops U22b and U22a, through ORgates U21b and U21a, respectively. The resistance element and clutchcurrent output feedback ensure that the output drive of the resistanceelement drive circuitry 112 and clutch drive circuitry 114 is regulatedto the reference output provided by the digital analog converters 120₁,120₂. The frequency of the PWM clock input to flip flops U22b and U22ais approximately 2 kilohertz and is provided by counter 162. Theresistance of resistance element 22 is nearly linear with the currentprovided by the output drive of circuitry 112 (FIG. 17). Current iscontrolled by writing to the DAC A output of DAC chip 121. Maximumoutput of the DAC corresponds to 1.67 amps which will provide aresistance torque of approximately 250 inch-lbs.

A unique feature incorporated into the system for controlling resistanceelement 22 is provision for full power voltage ramping of resistanceelement 22 when increasing the resistance thereof. Magnetic particleresistance element 22 and clutch 26 are high inductance devices whichrequire a certain time t to reach the requisite torque desired. As shownin FIG. 16, the ramp-up time of the current is proportional to theamount of voltage which is provided, and the slope of the currentincrease with respect to time t is proportional to the amount of voltageprovided into the internal coils of resistance element 22 and clutch 26.Although the proportionality of resistance torque to the current i isalmost linear, as shown in FIG. 17, it is desireable in the evaluationand training system of the present invention and particularly theisokinetic test mode, to reduce the time t required for resistanceelement 22 to provide resistance in response to the changes in torque onshaft 18 to provide dynamic resistance for the test subject. Thus, asshown in FIG. 18, the electronic control system and software of thepresent invention provide that the current output on BRAKE₋₋ A, BRAKE₋₋B is driven to 100% when ramping resistance element 22 to a particularresistance level, such as 25% of full power or 62.5 inch-lbs. In orderto control the ramp-up of resistance element 22 in this manner, theresistance element output sense signals BRK₋₋ CUR₋₋ SEN and clutchoutput sense signals CLH₋₋ CUR₋₋ SEN are fed back to comparators U25aand U25b, respectively, which compare the actual current output to thereference output provided by digital analog converter 120₁, 120₂,respectively. If the current is below the desired level, flip flops U22band U22a are clocked low on the next incoming clock cycle from PWM₋₋CLK. Thus, once the resistance element or clutch current reaches itsthreshold level to provide the desired amount of torque, the drivers areturned off.

In addition, a 200Ω resistor R31 is provided between the BRAKE₋₋ Aoutput and the 24 volt DC input to provide a reverse current to theresistance element when the resistance element is turned off to reducethe residual drag thereof. There is a current offset of approximately-60 milliamps to supply a reverse current to reduce the residual dragwhen the resistance element is shut off. As the clutch is lower intorque, this reverse current is not necessary.

Torque sensor 20 provides an analog voltage output to bridge amplifier150, whose output (ANALOG1) is coupled to analog-to-digital converterU28 (FIG. 13) which digitizes the signal for computer 180. While twoanalog converters U28 and U29 are provided on the board, presently onlyA/D converter U28 is used. A/D converter U29 is provided for future useand may, in one embodiment, be used in conjunction with a forcetransducer for sensitivity testing with respect to stationary post 15.A/D converter U29 has an input coupled to a plug P1 which may also beused to couple A/D converter U29 to the torque sensor if necessary.

FIG. 15 shows timing and watchdog circuit 160 of the present invention.Many of the signals generated by timing chip 162 have been discussedpreviously in the context of their operations with respect to theparticular circuits utilized in the electronic control system of thepresent invention. The specific means chosen to implement the requisitetiming signals required for the electronic controller of the system maybe 82C54-2 programmable clock generator 162. The counter 0 output ofchip 162 is utilized to generate the HCTL clock in a range of 2 Mhz-100kHz nominally 1 Mhz. The counter 1 output generates PWM₋₋ CLK in a rangeof 10 Khz-500 Hz, normally provided at 2 kHz. The counter 2 outputprovides the interrupt time-through buffer U3A which, as discussedabove, must be enabled by IRQENA (low) from port A of peripheral portcontroller 102.

Watchdog circuit 165 ensures that the electronic controller and drivehardware is shut down in the event of a software problem. For thewatchdog circuit to remain inactive, there must be a port access atleast every other interrupt clock (OUT2). A watchdog activation willalso occur if the interrupt clock is too slow, e.g., less than 0.5hertz. The CLOCK2 output is provided to monostable multi-vibrator U5A,whose output is coupled to watchdog circuit U5A. Watchdog circuit 165essentially comprises monostable multivibrator U5A, and flip flops U1B,U7A, and U7B. Flip-flops U1B, U7A, and U7B have clock output OUT2coupled to their clock (CLK) inputs, and have their preset P inputs heldhigh.

The clear C inputs of flip-flops U1B, U7A, and U7B are gated from thePORT₋₋ SEL and IORW signals via OR gate U6A. Thus, as long as the systemsoftware accesses peripheral port controller 102, the flip-flops willnot increment, remaining cleared by the output of OR gate U6A. If,however, the software is not accessing the board, flip flops U1B, U7Aand U7B will act as a sequential shift register to output signal 8255₋₋RST via OR gate U6B which, when cycled with the output of multivibratorU5A, will generate the 8255₋₋ RST signal to reset the peripheral portcontroller 102. In turn, the motor controller 105 will be reset.

The status of watchdog circuit 165 can be read on port C of peripheralport controller 102. As watchdog circuit 165 is not latched, if itbecomes active for a short time and then becomes inactive, the resetoutput (8255₋₋ RST) is removed. This reset condition can be detected byreading the control word of peripheral port controller 102.

Dual ripple counter U4 provides signals QA, QB and QG for use by PLD103to provide control outputs. An 8-megahertz oscillator U9 is coupled tothe 2A input of dual ripple counter U4. The 1A input is coupled to theclock 0 output (OUT0) of timing chip 162.

FIGS. 19-27 are flowcharts depicting the logical steps executed by thesoftware resident in computer 180 to perform various test modesdiscussed above. A printout of this software is included as Appendix Aof this application. It should be understood by those skilled in the artthat the flowcharts represent one embodiment of a method forimplementing the test modes of the evaluation and training system of thepresent invention; numerous other methods are suitable within thecontext of the system of the present invention and are intended to bewithin the scope of the claimed invention.

FIG. 19 is a flowchart of the main control program of the evaluation andtraining system of the present invention. As shown in FIG. 19, thesoftware control system first initializes the port hardware (step 182)discussed above with respect to FIGS. 9-15. A menu is then displayed onmonitor 210 (step 184) and the therapist prompted for a selection ofoperation modes by an input from keyboard 205 (step 186). The therapisthas an option to request an automated test sequence wherein the softwarewill implement, sequentially, isometric testing, isotonic testing,isokinetic testing, reaction time testing, and tap response testing.Alternatively, the therapist may select to individually perform theisometric, isotonic, isokinetic, reaction time, and tap responsetesting. The continuous passive motion mode is individually selectableand is, in the embodiment shown in FIG. 19, not part of the automatedtest sequence. It should be understood by those skilled in the art thatis within contemplation of the invention to incorporate the continuouspassive motion mode sequence into an automated test and training routinefor the evaluation and training system. It should also be understood bythose skilled in the art that it is within contemplation of theinvention to allow the therapist to preprogram any number of automatedtest sequences utilizing the individual isokinetic, isometric, isotonic,reaction time, tap response, and continuous passive motion modesubroutines. For example, in a customized sequence, different individualsubroutines may be linked to provide selective automated sequences forparticular test subjects.

Further, it should be understood that while for the sake of simplicitythe ensuing discussion refers to the selection of modes andinitialization of the system in terms of a therapist, as test monitor,and a test subject, as an individual whose muscles are under test, asuitable interface system may be utilized to allow the test subject toset system parameters and perform self testing and training exercises.Finally, the ensuing discussion also describes each of the operationaland test modes in terms of the basic ergonomic system incorporated inthe testing and evaluation system of the present invention. It should beunderstood that each of the attachments described above can besubstituted for rotational element 10 and stationary element 15 in thecontext of the following discussions.

In general, if the automatic testing sequence is selected (step 188),before proceeding with any of the specific testing subroutines, theextreme stops for rotating element 10 must be established by thesoftware control system. The extreme stops generally comprise rotationalpositions 0° and 360° of rotational element 10 with respect tostationary element 15. The initialize extreme stops function is alsoindividually selectable from the main menu (189) and must be preformedat least once before implementing any of the individual test modesequences.

FIG. 20 shows the initialize extreme subroutine 190. Initially (step191), the software turns the resistance element current off and engagesclutch 26 at a "full on" mode. Motor 22 is energized forcounterclockwise rotation at step 192 and rotary optical encoder 24 isread by motor controller 100 to determine the specific position ofelement 10 with respect to element 15. The control software monitorsmovement of element 10 via rotatory optical encoder 24 following themotion of element 10 to ensure that motor 22 has moved element 10 in atleast 0.5° increments every 0.1 sec. as shown by steps 193, 194, and195. When motor 22 stops, the equation (LAST₋₋ POS - POSITION)<0.5° willbe true, and processor 180 will set the position register in motorcontroller 105 to zero. Subroutine 190 thereafter initializes motor 22for clockwise rotation (step 197). In the control loop represented bysteps 198, 199 and 201, the software again ensures that motor 22 hasmoved element 110 in at least 0.5° increments every 0.1 sec., this timein the clockwise direction. When motor 22 stops, the software checks theposition of rotational element 10 and compares POSITION with the MIN₋₋ROTATION value stored in processor 180. If POSITION is greater than theMIN₋₋ ROTATION of element 10, torque transducer 20 is set to 0 (step203), the system is initialized and the GOOD STOPS flag set (step 204),and the routine exits. If not, the therapist is prompted with a "STOPSNO GOOD" message (step 205).

FIG. 21 shows the initialize exercise stop subroutine 200. The functionof this subroutine is to allow the therapist to set the maximumrotational exercise positions for element 10 which are suitable forevaluating and testing the left and right hands of the particular testsubject during each testing sequence. Subroutine 200 initially checks tosee if the GOOD STOPS flag has been set by the initialize extreme stopsubroutine 190. If not, the subroutine displays a "INITIALIZE EXTREMESTOPS" message (step 260) to display monitor 210, and exits subroutine200. The system thus requires that the extreme stops be initializedbefore proceeding into any of the test modes. If the "GOOD STOPS FLAG"is set, the system sets resistance element 22 and clutch 26 "off" (step215) and issues a "MOVE TO FIRST STOP" message (step 220) to monitor210. The "MOVE TO FIRST STOP" message is a signal to the therapist tomove rotatable element 10 to the first position the size of thepatient's hand with respect to the stationary post 15. Such positionwould be equivalent to the maximum linear length D (FIG. 3) which issuitable for the hand size of the particular test subject. This positionmay be anywhere between 0° and 180° for example, for a test of the righthand of the test subject, and likewise between 180° and 360° for a lefthand test. Subroutine 200 thereafter waits (step 225) for the therapistto enter a particular key hit, such as the "ENTER" key on keyboard 205,to indicate that element 10 has been moved to the first exercise stopposition. When the particular key is depressed by the therapist (step230), the software stores the first stop position (STOP 1) and proceedsto step 235 where, if the manual tap or isometric mode test has beenimplemented, the subroutine exits to proceed with subroutine 300, forisometric testing, or subroutine 700 for tap testing. If the therapisthas selected the isokinetic, isotonic, reaction time modes, or automatictest sequence modes, the message "MOVE TO SECOND STOP" is issued (240)to display monitor 210. The system then waits (245) for the therapist toset the second stop at a position (between 0°-180° or 180°-360°)equivalent to the maximum length D which is suitable for the testing ofthe test subject's hand. It should be understood that if the first stopposition is set for the right hand, the second stop position is set forthe left hand, and vice-versa. When element 10 has been positioned inaccordance with the distance D suitable for a test subject, thetherapist will hit the ENTER key the STOP2 position will be stored (step250). Subroutine 200 thereafter computes the start position (STARTPOS)and the stop position (STOPPOS) which may thereafter be used to directmotor processor 105 to position element 10 during the series of testingsequences.

Subroutine 300 for executing the isometric testing in accordance withthe system of the present invention is shown in FIGS. 22A and 22B.Subroutine 300 begins with execution of exercise stop subroutine 200discussed above. It should be understood from a study of the maincontrol program in FIG. 19, that if the software is executing theautomatic test sequence, subroutine 200 is only executed once for allexercise modes.

The purpose of isometric subroutine 300 is to allow the system of thepresent invention to provide a maximum resistive force to resistanceelement 22 and thereafter measure the torque which was applied by thetest subject to rotating element 10 relative to the axis 12 while notallowing the test subject to actually move element 10. In oneembodiment, the output of subroutine 300 is a numerical measurement ofthe torque and the maximum torque achieved in a sequence of testingrepetitions. At step 310, subroutine 300 directs motor 28 to moveelement 10 to the first start position established in the first half ofsubroutine 200. Subroutine 300 thereafter sets the resistance to a "fullon" mode (step 320). Subroutine 300 then enables (step 325) theisometric interrupts 330. As will be understood by those skilled in theart, the interrupt sequence will be enabled by the interrupt clocksignal output from clock 2 (OUT2) of timing chip 162.

As pressure is applied to element 10, interrupt sequence 330 reads thetorque translated to shaft 18 (step 332), and the position movement of(step 334), rotational element 10. At step 336, subroutine 330 checksthe variable TOR₋₋ DIR to determine whether the subject is applyingincreasing or decreasing torque on element 10. TOR₋₋ DIR is set by theprevious output data of interrupt sequence 330. In essence, interrupt330 continues testing for the maximum torque applied to rotationalelement 10 by the test subject until the test subject eases his or hergrip and the applied torque is decreased.

On the initial interrupt cycle, TOR₋₋ DIR is set to DECREASING. At step350, interrupt 330 queries whether the torque is greater than the TOPtorque, a constant of approximately 5 in-lbs. If so, TOR₋₋ DIR is set toINCREASING and the interrupt exits. If not, the interrupt routine exits.

On the next interrupt cycle, if the magnitude of the torque isincreasing (TOR₋₋ DIR INCREASING), subroutine 330 checks to determinewhether the magnitude of the torque is less than the "bottom" torque,the "bottom" torque being a constant of approximately 2 in-lbs. If so,the subroutine 330 increments the repetition count (step 340) and theTOR DIR is set to DECREASING. If the applied torque is greater thanBOTTOM subroutine 330 checks whether the applied torque is a new maximummeasured torque (MAX₋₋ TORQUE) (step 344). If measured TORQUE is a newMAX₋₋ TORQUE, the MAX₋₋ TORQUE variable is set to the new measuredmaximum value and the interrupt exits. If not, the interrupt exitswithout resetting MAX-TORQUE. When the requisite number of repetitionshave been incremented, subroutine 300 displays the maximum torque,torque average and the number of repetitions programmed by the therapist(360) and waits for an escape key hit by the therapist on keyboard 210.When the escape key is hit, subroutine 300 exits to the next sequentialstep of the automatic process, or the main menu depending on thepreselected independent or automatic routine (see FIG. 19).

Subroutine 400 for implementing the isotonic test mode of the presentinvention is shown in FIGS. 23A and 23B. In an isotonic mode sequence,the system will apply a constant current drive to resistance element 22,therefore providing a constant torque resistance against any movement bythe test subject of element 10. The rotational velocity applied by thetest subject to element 10 is allowed to vary. Subroutine 400 beginswith initialize exercise stop subroutine 200 to ensure that the exercisestops have been preprogrammed in accordance with the sequences discussedabove. Again, in the automated test sequence, this subroutine will havebeen performed prior to the isometric test sequence.

At step 410, the isotonic subroutine 400 displays a "ENTER ISOTONICTORQUE" message on display monitor 210 and awaits input from thetherapist at step 420. When the requisite torque determined by thetherapist to be suitable for the particular test subject has beenentered, the system moves to initialize interrupts 430.

Again, the interrupt sequence is controlled by the interrupt clock.Essentially, interrupt sequence 430 reads the torque translated to theshaft 18 by force applied by the test subject onto element 10 (step 432)reads the rotational position of element 10 (step 434), and computes thework provided by the test subject on shaft 18 by multiplying the torqueby the change in position of element 10.

After the interrupts are enabled (step 425), the test begins whenrotational element 10 is moved to the first start position (the firstexercise stop) (step 440) and resistance element 22 is energized byprogramming the requisite torque level into digital analog converter120. After energizing resistance element 22 to the specified torquelevel, at step 450, the system will wait for the test subject toposition rotating element 10 at the end-stop position. When movement ofrotating element 10 has been completed, at step 455, the repetitioncount will be incremented, and the system will return rotational element10 to the start position (step 440). If, at step 450, the repetitioncount has reached the desired level or the element 10 is not at the stopposition, the subroutine will proceed to step 460 where, if an escapesequence is initiated, the subroutine will exit. If the escape sequenceis not initiated, the system will continually display the torque,maximum torque and repetition count of the isotonic test sequence (step465). The display will remain on and the subroutine will awaitpositioning of the element 10 at the stop position.

Isokinetic subroutine 500 for implementing the isokinetic test mode inaccordance with the present invention is shown in FIGS. 24A and 24B.Again, subroutine 500, like subroutines 400 and 300, requires theexercise stops for the particular test subject to be programmed inaccordance with the instructions set forth under subroutine 200discussed above, either at the beginning of the individual isokinetictest sequence or at the beginning of an automated test sequence. In theisokinetic test mode, the system will dynamically adjust the torqueresistance applied to the shaft 18 under a force supplied by testsubject to maintain a constant velocity of movement of element 10 withrespect to element 15.

Subroutine 500 immediately initializes interrupts 510 shown in FIG. 24B.

The isokinetic interrupt sequence 510 represents a dynamic control loopfor providing the variable position/torque data to computer 180 todetermine and implement the requisite resistive force required tomaintain constant rotational velocity under the force applied by thetest subject, which is necessary in isokinetic testing.

Isokinetic subroutine 500 first positions rotational element 10 at thefirst exercise stop position (step 550). Subsequently, at step 560, theservo loop which is utilized to dynamically adjust the torque resistanceapplied to shaft 18 is set. The system then checks, at step 570, todetermine whether the servo loop flag is set. As will be understoodafter an analysis of the isokinetic interrupt sequence 510, if the servoloop flag is not set, the repetition counter increments at step 580 andthe subroutine 500 loops to step 550. If the servo is set at step 570,the system awaits an escape sequence at step 590. If the escape sequenceis not supplied at step 595, the system will display the torque,velocity, and repetition count.

Isokinetic interrupt sequence 510 will be hereafter described withreference to FIG. 24B. Interrupt sequence 510 begins with step 512 and514 wherein the torque and position of shaft 18 are read via torquesensor 20 and rotary optical encoder 24, respectively. At step 516,interrupt sequence 510 checks to determine if the servo flag is set viastep 560 as discussed above. If the servo flag is not set, the interruptexits. If the servo is set at step 518, the system sets the ACCELERATIONvariable equal to the measured TORQUE divided by INERTIA. At step 520,the ACCELERATION variable is set to the current ACCELERATION variablevalue minus the DECELERATION. At step 522, the target velocity variable(TAR-VEL) is set to the current value of TAR₋₋ VEL plus ACCELERATION.Next, at step 524, the target position (TAR₋₋ POS) is set equal to thecurrent TAR₋₋ POS plus TAR₋₋ VEL. At step 526, the velocity error (VEL₋₋ERR) is set to be equal to the actual velocity (ACTUAL₋₋ VEL) minus thetarget velocity (TAR₋₋ VEL). The position error variable is then set tobe equal the actual position (ACTUAL₋₋ POS) minus the target position(TAR₋₋ POS). The output drive current necessary is then computed by theequation: DRIVE=(LAST DRIVE+((VEL₋₋ ERR) - (LAST₋₋ VEL₋₋ ERR * ZERO₋₋GAIN)) * ERROR₋₋ GAIN - LAST₋₋ DRIVE * POLE₋₋ GAIN) where the velocityerror (VEL₋₋ ERR) is computed as set forth above, the last velocityerror (LAST₋₋ VEL₋₋ ERR) and last drive (LAST₋₋ DRIVE) are variablesrecording the velocity error and drive value set forth in the previousinterrupt cycle; ZERO₋₋ GAIN is approximately 20; ERROR₋₋ GAIN isapproximately 100; and POLE₋₋ GAIN is approximately 5. The dynamics ofthe servo response can be changed by varying the values of ZERO₋₋ GAIN,ERROR₋₋ GAIN, and POLE₋₋ GAIN, as will be understood by those skilled inthe art. The sequence then proceeds to step 532 where the LAST₋₋ DRIVEvariable is set to the current DRIVE value. The LAST₋₋ VEL₋₋ ERRvariable is sent to the current VEL₋₋ ERR value, and, at step 536,resistance element 22 is energized to provide the drive current plusdrive offset values computed at step 530. If, at step 540, the rotatableelement 10 is not at the stop position, the interrupt loops to exit. Ifrotational element 10 is at the stop position, interrupt sequence 510proceeds to step 542 where the servo loop flag is reset and theinterrupt exits. As will be well understood by those skilled in the art,the resolution of the isokinetic test sequence is thus dependent on theinterrupt clock cycle.

Reaction time subroutine 600 will be described with reference to FIGS.25A and 25B. The reaction time proprioceptive test operates by movingrotatable element 10 in a first direction and, at a random point intime, reverses the direction of element 10, requiring the test subjectto respond by applying force against the direction reversal as soon asthe direction reversal is detected. In this manner, the reaction time ofthe test subject to the direction reversal is measured.

As shown in FIG. 25A, subroutine 600 begins by requiring that theexercise stops be initialized using subroutine 200. At step 605,reaction time interrupts 610 are enabled; the interrupt sequence isdescribed below with respect to FIG. 25B. Sequence 600 thereafter movesrotatable element 10 to the start position for the test at step 630. Atstep 635, the reaction time variable is set to 0. At step 640, a randomposition between start position and stop position is generated androtating element is allowed to move to the set random position. At step650, when the rotatable element 10 has reached the random position,reaction flag is set and motor 28 is caused to reverse direction. Afterinterrupt sequence 610, described below, computes the reaction time, thedisplay sets forth the torque, reaction time, and repetition count atstep 655. The system then queries whether the rotating element has beenmoved 25° against the test subject. If so, at step 662, the reactionflag is reset and, at step 665, the repetition counter is incremented.If, at step 660, the rotatable element 10 is not moved 25°, thesubroutine 600 queries whether the reaction flag has been turned off. Ifthe reaction flag has been turned off, the repetition counterincrements. If not, the subroutine checks to see if the escape key washit at 670 before looping back to step 655. Once the repetition counterhas been incremented, the subroutine loops to step 630 and begins thenext increment sequence of the test.

Reaction time interrupt sequence 510 will be described as with respectto FIG. 25B. At the beginning of interrupt sequence 610, the position ofrotational element 10 is read (step 612) and the torque translated tothe shaft 18 by force applied to element 10 by test subject is also read(step 614). At step 616, the interrupt checks to see if the reactionflag has been set at step 650 of subroutine 600. If not, the interruptexits. If the reaction flag has been set, at step 618, interrupt 610determines whether the torque is greater than the threshold torque. Ifso, the reaction flag is reset at step 620. If not, the system checks todetermine whether the test subject has moved rotatable element 10 2°against the rotational direction of motor 28. If so, the reaction flagis reset. If not, the REACTION TIME counter is incremented by one atstep 624. Thus, the resolution of the reaction time counter is dependenton interrupt clock sequence. Once the REACTION TIME counter variable isincremented, the interrupt exits.

FIG. 26A shows the functional sequence for implementing the tap responsemode of the testing and evaluation system of the present invention. Inthe tap response testing mode, rotational element 10 will be moved tothe first exercise stop set in subroutine 200, the resistance elementwill provide a high rotational resistance, and the subject will beprompted to repeatedly contract his or her grasp on rotational element10 and stationary element 15. The tap response mode thus measures thereactive contraction time of the particular test subject.

As shown in FIG. 26A, tap response subroutine 700 begins by requiringthat at least one of the exercise stops be initialized by initializeexercise stops subroutine 200, as discussed above. Subsequently, brake22 is turned to a "full on"0 mode (step 710) and tap interrupts 720 forthe system are enabled. Subsequently, subroutine 700 displays maximumtorque provided by the test subject during the test sequence (MAX₋₋TORQUE), the tap time, and number of repetitions completed for each taptest sequence. Step 760 requires an escape key be hit to exit the tapmode. Until the escape is issued, the subroutine loops maintains thetest result display.

Tap interrupt sequence 720 controls the tap measurement sequence andbegins by reading the shaft torque (step 712), reading the position ofrotational element 10 (step 714), and incrementing the tap counter (step716). If the incoming tap cycle detects that the grip of the testsubject is applying a maximum torque, at step 722, the MAX₋₋ TORQUE isset equal to the measured torque and the interrupt exits. If not, atstep 726, the interrupt checks to determine whether the measured torqueis less than the lower torque setpoint (BOTTOM). If so, the torquedirection variable (TOR₋₋ DIR) is set DOWN (step 728) and the interruptexits. As will be readily understood, the TOR₋₋ DIR, DOWN condition willonly be met when the grip of the test subject is effectively released.

On the next succeeding grip by the test subject, if TORQUE is notgreater than MAX₋₋ TORQUE, and not less than the BOTTOM torque, at TOR₋₋DIR set to DOWN and TORQUE greater than the upper torque setpoint (TOP),at step 730, TOR₋₋ DIR is set to UP (step 732), and an audible tone isissued (step 734). Subsequently, at step 736, the display issues the TAPTIME (equal to the value of TAP₋₋ COUNT,) and the maximum torque, andresets the TAP COUNT and MAX₋₋ TORQUE equal to 0. Finally, therepetition counter is incremented (step 738).

Continuous passive motion subroutine 800 for implementing the continuouspassive motion mode of the testing and evaluation system of the presentinvention is shown in FIGS. 27A and 27B. As noted above, the continuouspassive motion mode directs rotational element 10 about a predeterminedrotational exercise movement scheme which directs the extension andcontraction of the test subject's muscles.

Subroutine 800 begins by requiring execution of initialize exercisestops subroutine 200, described above. At step 810, an "ENTER CPMVELOCITY" message is output to display monitor 210. The therapist isthus prompted to enter a suitable velocity for the individual testsubject via keyboard 205. At step 815, the subroutine 800 will retrievethe input velocity and at step 818, move element 10 to the startposition (the first exercise stop) and enable the CPM interrupts 820. Asshown in FIG. 27B, CPM interrupts 820 comprise reading the torque 812and then reading the position 814 to allow the system to monitor boththese elements during the CPM mode. At step 825, subroutine 800 waitsfor the keyed signal from the therapist governing the test. Once the keysignal is entered (step 830), motor 28 is energized to move rotationalelement to the first position. Subroutine 800 continuously checks (step835) to determine whether motor 28 has moved element 10 to the stopposition (STOP₋₋ POS). Until rotational element 10 reaches the stopposition, the therapist has an option to hit the ESCAPE key (step 840)and end the continuous passive motion mode. Otherwise, at step 845,during the rotational movement of rotational element 10, the displaywill output the torque, velocity, and repetition count while movingrotational element 10 from the start position to the stop position. Ifrotational element 10 reaches the STOP position, motor 28 is energized(step 850) to move in a reverse direction, back to the START position.Again, subroutine 800 continuously checks to determine if rotationalelement 10 has reached the START position. When the START position isreached, the repetition counter is incremented (step 860) and subroutineloops back to step 830. If the rotational element has not reach the STOPposition, the therapist has the option of entering the escape key atstep 865 to exit the subroutine. As will be noted at step 870, if therotational element has not reached the STOP position and no escape keyis hit, the torque, velocity, and repetition count are continuouslydisplayed during the continuous passive motion mode.

A sample data output report for the system is shown in FIG. 28. As showntherein, the outputs of isometric subroutine 300 (average peak torque),isotonic subroutine 400 (work per repetition), isokinetic subroutine 500(average peak torque), tap response (tap frequency and average taptime), and reaction time (average reaction time) are output to eithermonitor 210 or printer 207. In addition, a graph of the torque appliedat each particular position throughout the rotation of element 10 (orthe appropriate accessory) is also displayed, along with the subject'srange of motion and the exercise stop positions.

The numerous aspects of the testing and evaluation system of the presentinvention will be apparent to those skilled in the art. Other aspects ofthe system are contemplated as being within the scope of the presentinvention and within the scope of the specification, and the attachedclaims. ##SPC1##

We claim:
 1. A system for isolating, evaluating and exercising musclegroups of a hand of a test subject, comprising:means for detecting themovements of the hand during abduction, opposition, flexion or extensionof several or individual digits of the hand, said means for detectingtranslating the movements into rotational data for the system andeffectively isolating the movements of said several or individual digitsso that movements of other muscle groups of the test subject are notdetected by the system; and means for providing a variable resistance tothe means for detecting and for ascertaining the force applied to themeans for detecting by the movements of said several or individualdigits, said variable resistance including isotonic, isokinetic, andisometric modes of resistance against said several or individual digits.2. The system of claim 1 wherein the means for detecting comprisesastationary element for securing a first portion of the hand; and arotational element mounted for rotation about an axis positionedadjacent the stationary element and coupled to the means for providingresistance, the rotational element interacting with a second, movingportion of the hand, such that any movement of the second portion of thehand rotates the rotational element about the axis subject to the meansfor providing resistance.
 3. The system of claim 2 wherein the means forproviding and ascertaining comprisesresistance means for providing acontrolled resistance to the rotational element; means for sensingtorque applied to the rotational element by the movements of said movingportion of the hand; means for measuring the rotational velocity andposition of the rotatable element; means for selectively positioning therotational element; and control means, coupled to the resistance means,means for sensing, means for measuring, and means for selectivelypositioning, for controlling the resistance applied by the resistancemeans, for receiving data input from the means for sensing and means formeasuring, and for directing the means for selectively positioning,wherein the control means may direct the resistance means and means forselectively positioning to perform said isokinetic, isotonic, andisometric modes, and continuous passive motion, and proprioceptive testsequences.
 4. The system of claim 2 wherein the means for providing aselective variable resistance further includes:means for controlling theresistance to rotation of the rotational element about said axis, suchthat the isokinetic, isotonic, and isometric modes of resistance areprovided to the rotational element.
 5. The system of claim 1 wherein themeans for detecting the movements of said at least one muscle groupincludes means for detecting the supination and pronation of theforearm.
 6. The system of claim 5 wherein the means for detecting themovements of said at least one muscle group further includes means fordetecting internal and external rotation of the shoulder.
 7. The systemof claim 1 further including a housing enclosing the means for providingand means for detecting, wherein the means for detecting includes astationary member coupled to the housing, and a rotational memberrotatable about an axis positioned adjacent to the stationary elementsuch that, upon rotation of the rotational member, a linear distancebetween the stationary element and the rotational element is varied. 8.The system of claim 7 wherein the rotational member may be rotated in acounterclockwise direction and a clockwise direction thereby providingmeasurement of both a left and a right hand, respectively.
 9. A compactapparatus for evaluation and correction of various actions of the humanhand, comprising:means for isolating and testing the abduction,opposition, flexion or extension functions of the hand and individualdigits of the hand, the means including a rotational element and meansfor providing a variable resistance to the rotational element; controlmeans for controlling the magnitude of the variable resistance appliedto the rotational means such that the resistance is varied to provide atleast isotonic, isokinetic, and isometric modes of resistance; and meansfor providing data signals from the rotational means to the controlmeans, including means for providing data as to the rotational positionof the rotational means and means for providing the magnitude of thetorque exerted on the rotational means.
 10. A device for evaluating andexercising a hand of a test subject, comprising:means for isolating andtesting the abduction, opposition, flexion and extension of the hand andindividual digits of the hand, said means including a first fixture anda second fixture, the first fixture being movably positioned adjacent tothe second fixture to translate movements of the hand and individualdigits into rotational data, the second fixture being fixed, the firstand second fixtures effectively isolating said movements from movementsof other parts of a human body; and means, coupled to the first fixture,for providing isotonic, isometric, and isokinetic resistance modes tothe movements of the hand and digits.
 11. The system of claim 10 whereinthe means for providing includesmeans for providing a variableresistance to the first fixture responsive to a force applied thereto bythe movements of the test subject, and means for measuring the forceapplied by the movements of the test subject, wherein during theisokinetic mode a force applied by the means for providing, relative tothe force applied by the test subject, is such that a constantrotational velocity is maintained for the first fixture.
 12. The systemof claim 10 wherein the means for providing includesmeans for providinga variable resistance to the first fixture responsive to a force appliedthereto by the movements of the test subject, and means for measuringthe force applied to the first fixture by the movements of the testsubject, wherein during the isotonic mode a force applied by the meansfor providing, relative to the force applied by the test subject, isconstant, such that the first fixture has a variable rotationalvelocity.
 13. The system of claim 10 wherein the means for providingincludesmeans for providing a constant, high resistance to the firstfixture responsive to a force applied thereto by the movements of thetest subject, and means for measuring the force applied by the movementsof the test subject, wherein during the isometric mode a force appliedby the means for providing which is greater than the force applied bythe test subject such that the test subject cannot move the rotationalelement.
 14. The system of claim 10 wherein the means for providingincludesmeans for providing a constant, high resistance to the firstfixture responsive to a force applied thereto by the movements of thetest subject, means for measuring the force applied by the movements ofthe test subject, and means for positioning the first fixture along arotational path, wherein the means for positioning initiates movement ofthe first fixture which elicits a reactive response from the testsubject, and the means for controlling further includes means formeasuring the reaction time of the test subject.
 15. The device of claim10 wherein the movements of the hand include palmar flexion, digitflexion, dorsiflexion, abduction, opposition, radial deviation and ulnardeviation.
 16. The device of claim 10 further including means attachableto the first and second fixtures for adapting said fixtures to one ormore of the digits of the hand.
 17. A hand exercise and evaluationapparatus, comprising:a grip fixture, the grip fixture including astationary component and a moving component, the moving componentmeasuring and isolating movements of at least one muscle group of thehuman hand and the individual digits of the hand; and a resistancecontrol system, coupled to the moving component, the resistance controlsystem including means for providing resistance to the moving element ina variety of modes of operation such that the resistance provided to themoving component provides an isometric, isokinetic, isotonic and passiveresistance on the moving element.